Measurement of Alcohol Use Among HIV-Positives in Uganda

乌干达艾滋病毒阳性者饮酒情况的测量

• 批准号: 7119462
• 负责人: JUDITH ALISSA HAHN
• 金额: $ 17.2万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-30 至 2008-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7119462
• 关键词: AIDS therapy; Africa; HIV infections; alcoholic beverage consumption; antiAIDS agent; biomarker; breath tests; clinical research; high performance liquid chromatography; human subject; interview; questionnaires; sample collection; therapy compliance

DESCRIPTION (provided by applicant): This is a revised proposal to validate novel biomarkers of alcohol use, and to use the validated biomarkers to examine the validity of new and standard self-reported measures of alcohol use, among persons infected with HIV in Uganda. Low cost and free HIV antiretroviral therapy (ART) has been increasing in sub-Saharan Africa. However, alcohol use is pervasive in Uganda and may threaten treatment outcome by impairing treatment adherence, increasing the risk of medication related hepatotoxicity, and reducing the bioavailability of ART, leading to sub-therapeutic medication levels and viral resistance. Measuring alcohol exposure in Uganda is problematic because (1) ubiquitous home-brews are served in non-standard drink volumes, (2) the alcohol concentration in these may vary widely, (3) the identification of alcohol related problems may be culturally dependent, and (4) persons receiving or hoping to receive ART that is in short supply may under- report their alcohol consumption. Several biomarkers of short-term and prolonged heavy alcohol use (ethyl glucuronide, ethyl sulfate, phosphatidyl ethanol, and fatty acid ethyl esters) have shown outstanding test characteristics in North America and Europe but have not been tested in Africa. In this study, 75 HIV- infected persons in Mbarara, Uganda, will be recruited from an existing NIH-funded cohort of HIV infected persons, and a high seroprevalence hospital-based HIV counseling and testing program. We will stratify by gender, ART status, and recent drinking, including equal numbers of abstainers, moderate drinkers, and heavy drinkers. We will first conduct baseline interviews using newly developed alcohol consumption and standard alcohol screening questionnaires and collect specimen samples. Next, we will validate the biomarkers using breathalyzer tests conducted at daily home visits, over a period of three weeks. Last, we will use biomarkers with high validity to examine the utility of the new and standard alcohol consumption surveys administered at baseline. PUBLIC HEALTH SUMMARY: Alcohol use is pervasive but difficult to measure in Uganda, as most drinks are home-brews, and served in non-standard drink sizes, with varying alcohol concentration. Alcohol use may impact HIV treatment adherence and HIV outcomes, therefore valid measurements of alcohol use are needed to assess HIV treatment success. This study will validate novel biomarkers and new and standard self-reported measures of alcohol use among HIV positives in Uganda.

描述（由申请人提供）：这是一项修订的建议，旨在验证饮酒的新型生物标志物，并使用经过验证的生物标志物检查在乌干达感染HIV的人中，新的和标准的自我报告的酒精使用措施的有效性。撒哈拉以南非洲的低成本和游离HIV抗逆转录病毒疗法（ART）一直在增加。但是，乌干达的饮酒普遍存在，可能会威胁到治疗依从性，增加与药物相关的肝毒性的风险，并降低艺术的生物利用度，从而导致亚治疗药物水平和病毒抗性。在乌干达测量酒精暴露是有问题的，因为（1）无处不在的饮料量中供应无处不在的家庭酿酒，（2）酒精浓度可能差异很大，（3）与酒精相关的问题的识别可能依赖于培养物，并且（4）接受或希望在供应供应的艺术品的人（4）供应的供应量可能会在其饮酒中含量不足。短期和延长大量酒精饮酒的几种生物标志物（乙基葡萄糖醛酸乙酯，硫酸乙醇，磷脂酰乙醇和脂肪酸乙基酯）在北美和欧洲显示出了出色的测试特征，但在非洲尚未进行测试。在这项研究中，将从现有的NIH资助的艾滋病毒感染者组中招募75名受HIV感染的人，以及基于HIV医院的艾滋病毒感染者的较高的HIV艾滋病毒咨询和测试计划。我们将根据性别，艺术状况和最近的饮酒进行分层，包括相等数量的戒酒者，中度饮酒者和饮酒者。我们将首先使用新开发的酒精消费和标准酒精筛查问卷进行基线访谈，并收集样品样本。接下来，我们将在三周的时间内使用每日访问时进行的呼吸分析仪测试来验证生物标志物。最后，我们将使用具有高有效性的生物标志物来检查基线时进行的新的和标准饮酒调查的效用。公共卫生摘要：在乌干达，饮酒是普遍的，但难以测量，因为大多数饮料都是自家酿造的，并且以非标准的饮料尺寸服务，酒精浓度变化。饮酒可能会影响HIV治疗依从性和HIV结果，因此需要对酒精使用的有效测量来评估HIV治疗的成功。这项研究将验证乌干达的艾滋病毒阳性中新型生物标志物以及新的和标准的自我报告的酒精使用度量。